Test Your Knowledge of First-Line Treatment Decisions in Advanced NSCLC

First-line treatment in advanced non-small cell lung cancer (NSCLC) is increasingly layered – pre-treatment evaluation, regimen selection across biomarker subgroups, and recognizing and managing immune-related adverse events all converge in the early months of care. This 5-question clinical challenge tests decision points that may arise in first-line consultations.

Clinical Challenge

Which baseline finding most warrants specialist evaluation and individualized risk assessment before initiating first-line programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor therapy in advanced NSCLC?

Clinical Challenge

A patient with advanced NSCLC, no actionable driver alterations, a PD-L1 tumor proportion score of 30 percent, and an ECOG performance status of 1 presents with moderate disease burden. Which first-line approach best aligns with current guideline-supported options?

Clinical Challenge

Which clinical and imaging features are most characteristic of immune-related pneumonitis in patients on PD-1/PD-L1 inhibitor therapy?

Clinical Challenge

After excluding infectious etiology, what is the recommended initial management of grade 2 immune-related diarrhea or colitis in a patient on PD-1/PD-L1 inhibitor therapy?

Clinical Challenge

For new alanine transaminase (ALT) and aspartate transaminase (AST) elevation in a patient on first-line combination PD-1/PD-L1 inhibitor plus platinum-based chemotherapy, which workup approach is most appropriate?